Characteristics of Mental Health• Interpret reality accurately• Have a healthy self-concept• Able to relate to others• Achieve a sense of meaning in life• Demonstrate creativity/productivity• Control behavior• Adapt to change and conflict
Figure 1-1 A person with a healthy self-concept accepts herself as she is, including the fact that she has cerebral palsy. Source: PhotoEdit Inc.
Figure 1-2 Finding a sense of meaning in life is part of mental health. This hiker finds meaning in nature. Source: Omni-Photo Communications, Inc.
Mental Disorders Symptoms related to thinking, feeling, or behavior Caused by genetic, biological, social, chemical or psychological influences Result in impairment of functioning Meaning of illness related to culture Diagnostic and Statistical Manual of Mental Disorders definitive source for information People are not defined by their illness
Five-Axis Diagnosis System• Axis I: Clinical Psychiatric Disorders• Axis II: Personality Disorders or Mental Retardation• Axis III: General Medical Conditions• Axis IV: Psychosocial and Environmental Problems• Axis V: Global Assessment of Functioning
Role of the Nurse• Part of the multidisciplinary treatment team• Plans and provides care for the client• Collect data regarding the client’s mental and physical diseases, life stressors, and diseases effects on ability to function• Nurses focus on client’s response to illness
Incident of Mental Disorders Major problem for people all over the world Incidence underestimated Mental illness makes up 5 of the 15 leading causes of disability in developed countries Half of people in the US with major depressive disorder will have a psychiatric or substance abuse disorder in their lifetime
Figure 1-5 Risks and prevention factors for mental illness.
Figure 1-6 Educating adolescents about avoiding drug abuse is a primary prevention strategy for mental illness. Source: PhotoEdit Inc.
Stigma of Mental Illness• Mark of disgrace on mental illness in our culture• May feel too ashamed of mental illness to seek treatment• Physicians may hesitate to diagnose a mental illness for fear of labeling their client
Stigma of Mental Illness• Nurses should advocate for clients and avoid negative labeling• Do not explain medical illness according to fears and guesses• Base practice on evidence, not assumptions
Historical Perspectives• Mental illness documented back to Hippocrates• Treatment aimed at punishment• In the 1790s Phillippe Pinel started “moral treatment” of the mentally ill• Dorothea Dix crusaded for facilities to treat mentally ill• Mental health nursing became part of the curriculum for nurses in the early 1900s• Psychotropic drugs invented in 1950s
Figure 1-3 The “tranquilizing chair”was used to control people with mental disorders in the 19th century. Source: National Library of Medicine.
Figure 1-4 “The crib”was used to control people with mental disorders in the 19th century. Source: Stock Montage, Inc./Historical Pictures Collection.
Vulnerability of the Mentally Ill Among the most vulnerable in our society Disease prevents speaking effectively for themselves National Alliance for the Mentally Ill (NAMI) acts as an advocate providing support, education, and political advocacy Person who uses mental health services is called a consumer, not a client or patient
Vulnerability of the Mentally Ill• Most important role of nurse is as an advocate• Ask for mental health consultation is an important act of client advocacy
Figure 1-7 There are more charitable donations to benefit homeless animals than for homeless people. Source: Photo Researchers, Inc.
Resources The National Alliance for the Mentally Ill has information for consumers and their familieshttp://www.nami.org/ National Institute of Mental Health has information regarding symptoms, diagnosis, and treatment of various mental illnesses.http://www.nimh.nih.gov/index.shtml Psychiatryonline has information from the Diagnostic and Statistical Manual of Mental disorders available for many mental illnesses.http://dsm.psychiatryonline.org/book.aspx?bookid=22